Highlighting race and privilege has been key to wellbeing for East London NHS Foundation Trust

Sharing employees' experiences of bullying and harassment has also enabled the trust to foster a culture where staff feel empowered to call out unacceptable behaviour

The London Borough of Tower Hamlets, stretching from the Tower of London and Whitechapel in the west to Bromley-by-Bow in the east, is a melting pot of cultures. According to the 2011 Census, at least 80 languages other than English are spoken by residents in the borough.

It’s unsurprising, then, that a large NHS trust headquartered in the borough would also boast a workforce from many backgrounds. East London NHS Foundation Trust – which provides mental health, primary care and community health services to 1.8 million people across Tower Hamlets, as well as other London boroughs, plus Luton and Bedfordshire – has more than 6,500 staff, as well as many more bank workers also on its payroll.

In 2018, the trust began work to boost its wellbeing activities to take this diversity into account, using the ‘determinants of health’ approach, which uses factors such as lifestyle, finance and housing. At that point, explains chief people officer Tanya Carter, came the realisation that a better understanding of the issues affecting staff could help the trust support them.

Segmenting staff by gender and age to gain an idea of how many might be affected by menopause was the first project in this arena. “We might not have a significant proportion who are currently menopausal, but there are those who are perimenopausal, and a vast number of women in teams, some of whom are managed by men,” she explains. “So it’s about how we start that conversation.”

Taking into account the pillar of the trust’s strategy that focuses on staff experience led Carter to draw the link between this segmentation work, and staff from ethnic minorities reporting via the staff survey a worse experience of bullying. “Overlay that with daily occurrences of discrimination, how are they going to show up to work?” Carter explains. “We needed to provide a safe space for staff to have those conversations.”

A series of initiatives followed, designed to shine a light on the experiences of the trust’s ethnic minority colleagues, including race and privilege sessions, during which staff told stories about their experiences. “The reaction from some white colleagues was disappointment and sadness,” says Carter. “They hadn’t realised people they work with every day had been going through that.”

Because storytelling “really works in our organisation”, says Carter, and with broadly positive staff survey results yet indicators around bullying, harassment and aggression showing pockets of poor experience remained, later in 2019 the trust brought in the Empathy Museum to run a ‘Mile in my Shoes’ experiential exhibit, where staff could visit and were given another person’s shoes to literally walk in while listening to their story via headphones. An external facilitator was also brought in for sessions where staff told their experiences via drawings. “We wanted creative ways to keep the dialogue going,” Carter explains.

Armed with a catalogue of employees’ experiences, Carter raised the issue with the trust’s board. The stories were all then split into themes, including the experiences of Black women and inconsistent application of the Bradford factor, and shared at a session with more than 1,300 managers, during which one senior leader shared an example of when she could have handled a situation differently. “There was this moment when people felt they had permission to talk about what they hadn’t got right,” says Carter. The work further progressed with the help of a charity, which co-designed four monthly sessions with the trust’s most senior leaders to explain how the organisation could address white privilege and work towards becoming multicultural and anti-racist. “People were clearly uncomfortable, but there was also a desire to learn and get it right,” Carter says.

When Covid hit, having a proven disproportionate impact on ethnic minority communities, plus the events stemming from the murder of George Floyd, Carter saw this as the natural continuation of the trust’s race and privilege work. A recurring theme, she recalls, was people feeling they had to assimilate and change things about themselves – for example their name, hair or how they spoke. This led to the creation of the #MyNameReallyIs social media campaign, encouraging staff to tweet their full or un-westernised names. The campaign resulted in more than 22,000 impressions, and was the trust Twitter account’s second most popular tweet of 2020. 

At the height of the pandemic, the trust also implemented staff wellbeing initiatives. The BAME staff network requested access to vitamin D supplements, a three-month supply of which the trust provided to any employee who requested them (more than half did so) free of charge, under the #SunshineInMyPocket campaign, which is running again this year. Spearheaded by Carter, the trust also hosted a full timetable of online classes for the children of staff who were struggling to work from home and homeschool their children.

Employing several agency teachers and helping more than 1,500 children across seven weeks, the project went from idea to the first lesson in the space of a week and a half, and remains one of Carter’s proudest achievements to date. “I didn’t have time to ask for permission – it was one of those ‘seek forgiveness, not permission’ moments,” she laughs. Plenty of people have called into question whether providing free supplements and lessons for workers’ children is part of the trust’s remit as an employer, but Carter remains steadfast as the trust continues to go above and beyond to support employees’ wellbeing in 2022. “We asked, people told us what they needed, and we found a way to make it happen. People were just so grateful we had thought about it.”